Medical Audiology Final

What is NIHL?

Hearing loss caused by chronic or acute exposure to loud noise.

What is the typical audiometric pattern for NIHL?

High-frequency SNHL with a notch at 4,000 Hz.

What are common symptoms of NIHL?

Tinnitus, aural fullness, hyperacusis, recruitment, speech-in-noise difficulty.

What type of tympanogram is expected in NIHL?

Type A normal

What are common OAE findings in NIHL?

Absent or reduced OAEs in high frequencies

What is SSCD?

A vestibulocochlear disorder caused by a dehiscence (hole) in the bony canal of the superior semicircular canal.

Key symptoms of SSCD?

Sound/pressure-induced vertigo (Tullio, Valsalva), autophony, CHL-like loss, oscillopsia.

What is the hallmark diagnostic test for SSCD?

VEMPs with abnormally low thresholds (<70 dB nHL).

What is the typical audiogram finding in SSCD?

Low-frequency air-bone gap (pseudo-conductive loss).

Criteria of SSNHL?

≥30 dB SNHL at 3+ frequencies within 72 hours.

think of the 30-3-3

Common symptoms of SSNHL?

Sudden hearing loss, tinnitus, vertigo, aural fullness.

What is the treatment for SSNHL?

Corticosteroids (oral/intratympanic), possibly HBOT.

Site of lesion in SSNHL?

Cochlea (OHCs, stria vascularis, spiral ganglion).

What is EVA?

Enlarged vestibular acqueduct, A congenital inner ear malformation where the vestibular aqueduct is abnormally large.

Etiology and pathology of EVA

etiology

Congenital Structural abnormality

■ Isolated or part of a syndrome

Genetic Factors

■ SLC26A4

pathology

Abnormal transport of CSF

Typical hearing pattern in EVA?

Progressive, sudden, or fluctuating SNHL or mixed loss.

What triggers symptoms in EVA?

Head trauma, pressure changes, exertion.

What gene is associated with EVA?

SLC26A4 (Pendred syndrome).

Key symptoms of Ménière’s disease?

Episodic vertigo, fluctuating low-frequency SNHL, tinnitus, aural fullness.

SUDDEN DROP ATTACK / CRISIS OF TUMARKIN

What is the site of lesion in Ménière’s?

1. Swelling of the membranous labyrinth of the inner ear (endolymphatic duct and sac)

2. Fibrosis or temporal bone compression of endolymphatic duct and sac

3. Degeneration of spiral ligament, hair cells, dendrites, and apical spiral ganglion cells

What is the pathophysiology of Ménière’s?

Endolymphatic hydrops

What is the Crisis of Tumarkin?

sudden falls while remaining conscience, related to Otolithic Overstimulation due to increased cochlear pressure

What is AIED?

autoimmune inner ear disease, Inner ear dysfunction due to autoimmune activity.

Key symptoms of AIED?

Bilateral fluctuating SNHL, tinnitus, possible vertigo.

How is AIED diagnosed?

By exclusion, serial audiograms, bloodwork.

Treatment for AIED?

Systemic corticosteroids.

What is ototoxicity?

Damage to the inner ear due to medications (e.g., aminoglycosides, cisplatin).

Typical hearing loss pattern for ototoxicity?

Bilateral high-frequency SNHL.

What is a key audiologic tool for early detection?

OAEs (especially high-frequency).

Which drugs can cause reversible symptoms?

Aspirin, quinine, some diuretics.

What is a perilymph fistula?

A tear between the middle and inner ear causing perilymph leakage.

Common symptoms of PF?

Vertigo, fluctuating HL, aural fullness, nausea.

Triggers of PF

Straining, trauma, pressure changes.

Diagnostic test?

Positive fistula test (nystagmus with pressure).

What is an acoustic neuroma?

A benign tumor on the vestibular branch of CN VIII.

Key symptoms of acoustic neuroma

Unilateral SNHL, tinnitus, poor speech discrimination, imbalance.

Diagnostic test for AN

MRI + ABR (interwave latency delays (1 and 3, 1 and 5)

Audiogram finding for AN

Asymmetrical SNHL with rollover.

What kind of hearing loss is associated with diabetes?

Bilateral high-frequency SNHL, possibly cochlear or retrocochlear.

What causes hearing problems in diabetes?

Vascular damage (microangiopathy) affecting the cochlea and auditory pathways.

What percentage of people with diabetes may have HL?

10-55% of people diagnosed with disease have HL, ⅔ have hearing loss in HF, bilateral

What' is the common site of lesion for pts with diabetes

Cochlea and auditory nerve

What’s the etiology for diabetes related hearing loss

Elevated blood glucose levels and altered lipids and proteins cause vascular changes that

impact the stria vascularis and other cochlear anatomy + ANS

What are ABR findings in diabetes?

Delayed wave V and I–V interwave latency; even in those without HL.

What is vascular loop syndrome?

A condition where a blood vessel (usually AICA) compresses the cochlear or vestibular nerve.

What symptoms are associated with vascular loop syndrome?

Tinnitus Hearing Loss Hyperacusis Balance issues, vertigo Hemifacial spasms, facial pain

Audiological symptoms can mimic Meniere's disease or acoustic neuroma

Site of lesion for vascular loop syndrome

cerebellopontine angle, facial nerve, and cn viii

What kind of types are there for vascular loop syndrome?

Type 1 - CPA, Type 2 - Porus Acussticus, 50% through IAC, and Type 3 - latter 50% of IAC

What are the audio results typically for vascular loop syndrome?

Fairly normal, type A tymps, W1 and 2 interwave latency or 1-3